Incidental 18F-FDG PET/CT finding of COVID-1 pneumonia in asymptomatic patient diagnosed with lung abscess metastasis

Abstract A 66-year-old male patient, with chronic respiratory disease and right colon resection in March 2017 for colon low-grade adenocarcinoma was assessed for recurrence suggested by elevated levels of tumor marker and no evidence of oncological disease by CT scan. 18F-FDG PET/CT showed bilateral multiple peripheral FDG-avid foci that matched with a peripheral predominant ground-glass opacities (GGOs) observed in lower lobes and multiple FDG-positive enlarged lymph nodes were also identified in the mediastinum. Patient was hospitalized in March 14th 2020, one day after PET/CT scan, with cough, wheezing and fever, and was treated with anti-inflammatory drugs. A first SARS-CoV-2 RT-PCR in March 15th resulted as negative and patient was treated with antibiotic therapy lead to an improvement of respiratory symptoms. PET/CT scan was interpreted as a pneumonia foci. A deteriorating patient condition was observed, with respiratory symptomatology progression, fatigue and D-Dimer elevation and a new RT-PCR resulted positive. A week after PET/CT scan, hospitalization in intensive care unit was necessary for rapidly disease progression and severe respiratory distress syndrome and patient died four days later.